Politics and medicine in an election year Patients' rights: Health-care proposals in Maryland, Washington multiply to appeal to voters.

July 26, 1998

YOU CAN'T take politics out of health-care issues. Too much money is involved -- for patients, insurers and the government.

In Washington, Republicans are jockeying with Democrats to gain advantage in passing a "patients bill of rights." Initially, GOP conservatives opposed this notion, but pressure from voters propelled them to offer a limited plan to give consumers in managed-care situations greater medical choices.

In Maryland, politicians are playing a similar game. Democratic gubernatorial candidate Eileen M. Rehrmann wants to punish medical directors of health-maintenance organizations for denying treatment to patients. Not to be outdone, her primary-election rival, Gov. Parris N. Glendening, unveiled his own bill of rights for managed-care customers.

All these politicians share a desire to help consumers, but isn't it amazing that they waited to act until an election campaign?

Bottom-line considerations are the driving force for insurers. This sets up an inevitable clash with physicians and patients, who see quality medical care as the overriding priority.

But it's not that simple. Runaway health costs also pose a threat for consumers and for government. That's why public officials have encouraged the proliferation of managed-care groups.

The pendulum may have swung too far. Insurers have made it increasingly difficult for patients to get quick, comprehensive medical treatment. Doctors are buried in paperwork and restricted in their ability to provide appropriate care. Every time insurers ratchet down health-care costs, it brings howls of protest from physicians and angry consumers.

Politicians are responding to this outcry, but they must not tilt too far in the other direction. Putting HMOs in fiscal straitjackets could drive many out of business and send medical costs soaring again. Giving patients more explicit rights is a positive step, as long as politicians don't hurt legitimate efforts to wring out excess health-care costs.

Congress, in particular, ought to act this year. There are no national standards for HMOs. Most Americans aren't covered by state health-care statutes because of the nature of their medical-insurance coverage. Clear guidelines are needed to ensure that patients can get the medical care they want promptly and at a reasonable price.

This is one issue that should transcend partisanship. Consumers may be voters but they don't want to see health care become a campaign volleyball.